Authors’ conclusions: the probability of positive blood culture beyond 24 hours for a Gram-negative organism is small. Empiric antimicrobial treatment can be reduced after 24 hours to target only Gram-positive organisms in late onset sepsis and can be stopped in early onset sepsis unless clinical or laboratory parameters strongly suggest sepsis.
Reviewers’ commentary: depending on the local epidemiology, neonatologists could consider restrictively reviewing their antibiotic policies in the screening of neonatal sepsis, thus avoiding the overmedication of their neonates. It would seem reasonable to suspend treatment at 48 hours in patients with normal clinical and laboratory parameters.
Aparicio Sánchez JL, Cuestas Montañés E. Evid Pediatr. 2020;16:2
Authors’ conclusions: our mixtures analysis does not suggest an independent relationship of autism spectrum disorder or intellectual disability with any of the 25 chemicals examined together in this mixtures analysis.
Reviewers’ commentary: with this Bayesian probabilistic model, the authors clear up, at this moment, the uncertainty about the relationship between the main endocrine disruptors and autism spectrum disorders or intellectual disability, as the association shown in previous studies with “frequentist” analyzes is not demonstrated. It is an important result given the general concern about the effects of these universal pollutants.
Rodríguez-Salinas Pérez E, González Rodríguez P. Evid Pediatr. 2020;16:3
Authors’ conclusions: the flexed two-finger chest compression technique could provide adequate compression depth without increasing the hand-off time during single-rescuer infant cardiopulmonary resuscitation
Reviewers’ commentary: the flexed two-finger chest compression technique seems to improve the compression depth of the conventional two-finger technique, but not its frequency or degree of recoil. Although it is an alternative in resuscitation situations with a single resuscitator, studies should be extended before replacing the currently used two-finger technique for infant in action protocols.
Ochoa Sangrador C, Andrés de Llano JM. Evid Pediatr. 2020;16:4
Authors’ conclusions: pediatric emergency crowding was associated with increased hospital admission at the index visit for the sickest children, and with return visits to the emergency department for those less sick.
Reviewers’ commentary: crowding of emergency departments was related to an increase in hospital admission for the sickest children during the initial visit and return visits in the following week among those less sick. This situation could improve with better inter-level communication promoting the follow-up in Primary Care after the first hospital emergency consultation.
Pérez González E, Aizpurua Galdeano P. Evid Pediatr. 2020;16:5
Authors’ conclusions: this large population-based study confirms the beneficial effect of varicella vaccination in children and the decrease in the pediatric herpes zoster incidence, significantly more pronounced in the vaccinated child population, but also present among unvaccinated children.
Reviewers’ commentary: the results of this 12-year retrospective follow-up of a large pediatric population of children vaccinated or not against varicella, show that the pediatric herpes zoster incidence has decreased globally in both groups, but especially in the vaccinated population. Studies should be continued to confirm that this trend is maintained in adulthood.
Martínez Rubio M.V, García Vera C. Evid Pediatr. 2020;16:6
Authors’ conclusions: the prevalence of childhood overweigh and obesity is high, but trends have stabilized in most European countries. There are substantial differences between countries. The growing prevalence in some Mediterranean countries is worrying.
Reviewers’ commentary: the prevalence of excess weight is high throughout Europe. Although trends seem to have stabilized, there is an increasing trend in Iberian countries (Spain and Portugal) compared to the Atlantic countries. This is directly applicable to our environment. Although the cause of overweight is multifactorial, acting on lifestyle, sedentary habits and daily sleep, among other factors, we could decrease the prevalence significantly.
Ortega Páez E, Ruiz-Canela Cáceres J. Evid Pediatr. 2020;16:7
Authors’ conclusions: a higher amount of gluten in the diet at 18 months was a risk factor for childhood onset Celiac disease in a general population cohort. The association was independent of when gluten was introduced in the infant diet.
Reviewers’ commentary: the results of this study suggest that children in the general population who ingest high amounts of gluten at 18 months have a higher risk of developing celiac disease later in childhood. However, methodological problems and the small increase in risk, which does not explain the increase in the prevalence of the disease in recent years, do not allow us to recommend changes in our practice based solely on the results of this study.
Aizpurua Galdeano P, Aparicio Rodrigo M. Evid Pediatr. 2020;16:9